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Chest tube clogging can lead to retained blood around the heart and lungs that can contribute to complications and increase mortality. [11] A common complication after thoracic surgery that arises within 30–50% of patients are air leaks. If a chest tube clogs when there is an air leak the patient will develop a pneumothorax.
A thoracostomy is a small incision of the chest wall, [1] with maintenance of the opening for drainage. [2] It is most commonly used for the treatment of a pneumothorax.This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger ...
In modern portable, digital chest drainage systems, the collection chamber is integrated into the system. During the suction process, fluid will be collected in the chamber and air discharged into the atmosphere. [2] Digital chest drainage systems have many advantages compared to traditional, analogue systems:
The flap allows for 1) passive drainage of the pleural space and 2) negative pressure to develop in the thoracic cavity due to it being easier for air to escape than to enter the chest. The lung can then expand to the chest wall and seal the inner opening of the flap. [3] Other surgeons have subsequently proposed modifications to the procedure. [6]
Chemicals such as bleomycin, tetracycline (e.g., minocycline), [2] povidone-iodine, or a slurry of talc can be introduced into the pleural space through a chest drain. The instilled chemicals cause irritation between the parietal and the visceral layers of the pleura which closes off the space between them and prevents further fluid from accumulating. [3]
A tracheostomy tube may be single or dual lumen, and also cuffed or uncuffed. A dual lumen tracheostomy tube consists of an outer cannula or main shaft, an inner cannula, and an obturator. The obturator is used when inserting the tracheostomy tube to guide the placement of the outer cannula and is removed once the outer cannula is in place.
Once the nasogastric tube is inserted at the correct length, as determined previously, the tube is secured via tape. [3] Verification of correct placement most commonly involves the use of a chest X-ray, where the end tip of the tube can be seen in the stomach. [2]
[42] [43] This complication delays chest tube removal and is associated with an increased length of hospital stay following a lung resection (lung cancer surgery). [ 44 ] [ 45 ] The use of surgical sealants may reduce the incidence of prolonged air leaks, however, this intervention alone has not been shown to results in a decreased length of ...